Evidence map›Paper›PMID 34402047›Full record

ArticleHealth services research2021

Duration of medical home participation and quality of care for patients with chronic conditions.

Karen E Swietek, Marisa Elena Domino, Lexie R Grove, Chris Beadles, Alan R Ellis, Joel F Farley, Carlos Jackson, Jesse C Lichstein, C Annette DuBard

Abstract readComparative Study
In one paragraph

Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Karen E SwietekNORC at the University of Chicago, Cambridge, Massachusetts, USA.
Marisa Elena DominoDepartment of Health Policy and Management, The Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID 0000-0003-4845-6261
Lexie R GroveDepartment of Health Policy and Management, The Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Chris BeadlesHealth Care Quality and Outcomes Program, RTI International, Research Triangle Park, North Carolina, USA.
Alan R EllisSchool of Social Work, North Carolina State University, Raleigh, North Carolina, USA.
Joel F FarleyCollege of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA.
Carlos JacksonCommunity Care of North Carolina, Inc., Cary, North Carolina, USA.
Jesse C LichsteinDepartment of Health Policy and Management, The Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
C Annette DuBardAledade, Inc., Bethesda, Maryland, USA.

Funding

UNC-CH TRAINING PROGRAM IN HEALTH SERVICES RESEARCHT32HS000032 · AHRQ · UNIV OF NORTH CAROLINA CHAPEL HILL · PI HOLMES, GEORGE M · 1989 to 2024
$8.2M
Research Capability to Study Comparative Effectiveness in Complex PatientsR24HS019659 · AHRQ · NORTH CAROLINA COMMUNITY CARE NETWORKS · PI DUBARD, CAROL ANNETTE · 2010 to 2010
$991k
AHRQ HHS R24 HS019659AHRQ HHS T32 HS000032
6 · The paper itself

Abstract

objectiveTo examine whether the length of participation in a patient-centered medical home (PCMH), an evidence-based practice, leads to higher quality care for Medicaid enrollees with multiple co-morbid chronic conditions and major depressive disorder (MDD). DATA SOURCES: This analysis uses a unique data source that links North Carolina Medicaid claims and enrollment data with other administrative data including electronic records of state-funded mental health services, a state psychiatric hospital utilization database, and electronic records from a five-county behavioral health carve-out program. STUDY

designThis retrospective cohort study uses generalized estimating equations (GEEs) on person-year-level observations to examine the association between the duration of PCMH participation and measures of guideline-concordant care, including the receipt of minimally adequate care for MDD, defined as 6 months of antidepressant use or eight psychotherapy visits each year. DATA COLLECTION/EXTRACTION

methodsAdults with two or more chronic conditions reflected in administrative data, including MDD. PRINCIPAL

findingsWe found a 1.7 percentage point increase in the likelihood of receiving guideline-concordant care at 4 months of PCMH participation, as compared to newly enrolled individuals with a single month of participation (p < 0.05). This effect increased with each additional month of PCMH participation; 12 months of participation was associated with a 19.1 percentage point increase in the likelihood of receiving guideline-concordant care over a single month of participation (p < 0.01).

conclusionsThe PCMH model is associated with higher quality of care for patients with multiple chronic conditions and MDD over time, and these benefits increase the longer a patient is enrolled. Providers and policy makers should consider the positive effect of increased contact with PCMHs when designing and evaluating initiatives to improve care for this population.

Indexed as

AdultFemaleHospitalizationHumansMajor Depressive DisorderMaleMedicaidMental Health ServicesMiddle AgedMultiple Chronic ConditionsNorth CarolinaPatient-Centered CareQuality of Health CareRetrospective StudiesUnited Statesdepressionmedical homesmultiple chronic conditionsquality of care

Identifiers

PMID34402047
PMCPMC8515225

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.